Restless Leg Syndrome
Do you have an irresistible urge to move your legs in the evening or night-time? This could be restless leg syndrome (RLS). RLS is a common condition impacting on the sleep quality of many. Unfortunately there isn’t a specific test for RLS but a diagnosis is based on your symptoms alone.
Most of the time there is no underlying cause driving RLS but it is seen more often in pregnancy, iron deficiency and with some anti-depressant medications (1).
Symptoms range from mildly irritating to debilitating. To assess how severe your symptoms are it can be helpful to complete a validated questionnaire such as the one I have linked from The International RLS Study Group which grades symptoms from mild to very severe (2).
Grading symptoms can be helpful to pinpoint what management techniques would be best for you. For mild-moderate symptoms lifestyle measures can have a significant impact for preventing and managing episodes of RLS. These include undertaking moderate exercise, stopping smoking if you do so, reducing caffeine and alcohol and creating a positive sleep routine and environment (known as good sleep hygiene). Further information can be found on the RLS UK website which is a charity funded to support those living with RLS (3).
For more severe symptoms you may wish to consider drug treatment. The first line treatment Pramipexole has fallen out of favour in recent years due to an effect called augmentation (meaning it can make RLS worse over time). Medications such as Gabapentin taken in the evening time can be an effective treatment for chronic persistent RLS (symptoms more than twice per week) as can a low dose opioid such as codeine (although this should be balanced with the possibility of dependency). Again RLS-UK provide a comprehensive overview of the current medical treatments available and uses the most recent evidence from the Mayo clinic trial linked below (4).
If your RLS is driven by iron deficiency, pregnancy or another clear underlying cause then you can rest assured that it will likely go away with effective treatment of the driver. Unfortunately where there is no clear cause, RLS can persist and become progressive over time. It is therefore important to contact your doctor if you feel you have symptoms and start treatment where it will improve your quality of life.
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